PowerPoint® File

517 views

Published on

Published in: Business, Economy & Finance
0 Comments
1 Like
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total views
517
On SlideShare
0
From Embeds
0
Number of Embeds
1
Actions
Shares
0
Downloads
3
Comments
0
Likes
1
Embeds 0
No embeds

No notes for slide

PowerPoint® File

  1. 1. <ul><li>Opportunities and Challenges for Implementing HIT </li></ul><ul><li>Steven R. Simon, MD, MPH </li></ul><ul><li>August 2007 </li></ul><ul><li>Supported by a grant from the US Agency for Healthcare Research and Quality (AHRQ) </li></ul>
  2. 2. Prologue <ul><li>Widespread (universal?) EHR adoption by 2014 </li></ul><ul><li>Has adoption reached tipping point? </li></ul><ul><li>Do EHRs improve quality of care? </li></ul><ul><li>How are physicians using EHRs? </li></ul>
  3. 3. Outline <ul><li>Massachusetts e-Health Collaborative </li></ul><ul><li>Statewide survey of physicians, 2007 </li></ul>
  4. 4. Massachusetts e-Health Collaborative (MAeHC) <ul><li>Formed in 2004 </li></ul><ul><li>Major health care stakeholders </li></ul><ul><li>$50 million from Blue Cross Blue Shield of MA </li></ul><ul><li>Statewide EHR adoption </li></ul><ul><li>Demonstration project: </li></ul><ul><ul><li>Universal EHR adoption in 3 communities </li></ul></ul><ul><ul><li>Intra-community (and, ultimately, inter-community) data exchange </li></ul></ul>
  5. 5. Pilot Timeline Overview Activities 2004 2005 2006 2007 2008 ACP-MA summit MAeHC launch Community RFA launch Pilot communities announced EHR vendor RFP EHR vendor finalization Community EHR implementation Intra-community connectivity Evaluation Formal Pilot completion
  6. 6. PHYSICIANS “GOING LIVE”, BY COMMUNITY # MDs 2006 2007 North Adams (55) Newburyport (81) Brockton (305) 9 7 5 19 21 33 25 24 27 43 51 9 88 1 77 1 441
  7. 7. HEALTH INFORMATION EXCHANGE Northern Berkshire Example Patient recruitment Health data exchange Referrals mgmt Patient portal
  8. 8. State of the State: Physician Survey
  9. 9. Massachusetts Physician Survey <ul><li>Stratified random sample of practices (N=1884) </li></ul><ul><li>Randomly sampled one physician per practice. </li></ul><ul><li>2005: 1345 respondents (71%) </li></ul><ul><ul><li>EHR Adoption: 23% of practices, 45% of physicians </li></ul></ul><ul><ul><li>EHR Usage: wide variability in available functions and reported usage. </li></ul></ul>
  10. 10. 2007 Follow Up Survey (N=1345) <ul><li>May – July, 2007 </li></ul><ul><li>Multiple mailings to all 1345 respondents from 2005 </li></ul><ul><li>Excluded: moved, retired, deceased (N=200) </li></ul><ul><li>902 completed surveys (response rate 79%) </li></ul><ul><li>***Preliminary Analysis*** </li></ul>
  11. 11. Characteristics of Respondents with EHRs (N=562, >60% of sample) 60 Number of Patients/Week (median) 35% Incentives for HIT Adoption 28% Incentives for HIT Usage 22% 10+ Years with Practice 65% Teaching (Students/Residents) 32% Practice Ownership 44% 7+ Physicians in Office 16% Primary Care 39% 20+ Years Since Med School 37% Female
  12. 12. Please indicate all features of the EHR that you have available in your practice. For those features that you have, indicate the extent to which you use them. <ul><li>Laboratory test results </li></ul><ul><li>Laboratory order entry </li></ul><ul><li>Radiology test results </li></ul><ul><li>Radiology order entry </li></ul><ul><li>Electronic visit notes </li></ul><ul><li>Reminders for care activities (e.g. overdue health maintenance) </li></ul><ul><li>Electronic medication lists of what each patient takes </li></ul><ul><li>Electronic problem list </li></ul><ul><li>Can transmit prescriptions to pharmacy electronically or via electronic faxing </li></ul><ul><li>Electronic referrals or clinical messaging (secure e-mailing between providers) </li></ul>
  13. 13. Available EHR Functions, 2005 - 2007 63% 62% Electronic referrals 70% 45% Electronic transcription of Rx 76% 71% Electronic problem list 81% 75% Electronic medication lists 56% 53% Alerts and reminders 87% 84% Electronic visit notes 54% 54% Radiology order entry 78% 76% Radiology test results 51% 47% Laboratory order entry 86% 85% Laboratory test results (N=562) (N=387) Function 2007 2005
  14. 14. Usage* of EHR Functions, 2005 - 2007 *Most or all the time 50% 67% 72% 79% 40% 89% 69% 81% 64% 77% 2007 ▲ ▲ ▲ ▲ ▲ ▲ 43% Electronic referrals 45% Electronic transcription of Rx 58% Electronic problem list 67% Electronic medication lists 31% Alerts and reminders 71% Electronic visit notes 48% Radiology order entry 74% Radiology test results 52% Laboratory order entry 72% Laboratory test results 2005 Function
  15. 15. 2007 Massachusetts Survey Summary <ul><li>EHR adoption continues to increase </li></ul><ul><ul><li>Majority of Massachusetts’ physicians use EHRs </li></ul></ul><ul><li>Large segments of the physician population have “light” models of EHRs </li></ul><ul><ul><li>Just over half of physicians with EHRs have </li></ul></ul><ul><ul><ul><li>Lab and radiology order entry </li></ul></ul></ul><ul><ul><ul><li>Clinical decision support </li></ul></ul></ul><ul><li>Use of available EHR functions is increasing </li></ul><ul><li>Substantial proportions of EHR users do not use key functions that may improve quality and safety (order entry, e-Rx, and decision support) </li></ul>
  16. 16. Questions?
  17. 18. EHR SELECTION Preferred Vendors Selection Community down-select <ul><ul><li>EHR RFP distributed in May, 2005 </li></ul></ul><ul><ul><li>Over 30 responses received </li></ul></ul><ul><ul><li>Vendor Selection Committee validated 7 vendors to go forward </li></ul></ul><ul><ul><li>Community Steering Committees down-select to smaller number for individual physician choice in each community </li></ul></ul><ul><ul><li>3 or 4 in each community </li></ul></ul><ul><ul><li>Initial vendor fairs completed in each community and down-select complete </li></ul></ul>Physician choice <ul><ul><li>Individual physician vendor fairs </li></ul></ul><ul><ul><li>Each community developing different model of physician choice </li></ul></ul>

×